Περίληψη:
Background: Cardiac resynchronisation therapy (CRT) reduces morbidity and mortality in appropriately selected patients with heart failure and is strongly recommended for such patients by guidelines. A European Society of Cardiology (ESC) CRT survey conducted in 2008–2009 showed considerable variation in guideline adherence and large individual, national and regional differences in patient selection, implantation practice and follow-up. Accordingly, two ESC associations, the European Heart Rhythm Association and the Heart Failure Association, designed a second prospective survey to describe contemporary clinical practice regarding CRT. Methods and results: A survey of the clinical practice of CRT-P and CRT-D implantation was conducted from October 2015 to December 2016 in 42 ESC member countries. Implanting centres provided information about their hospital and CRT service and were asked to complete a web-based case report form collecting information on patient characteristics, investigations, implantation procedures and complications during the index hospitalisation. The 11 088 patients enrolled represented 11% of the total number of expected implantations in participating countries during the survey period; 32% of patients were aged ≥75 years, 28% of procedures were upgrades from a permanent pacemaker or implantable cardioverter-defibrillator and 30% were CRT-P rather than CRT-D. Most patients (88%) had a QRS duration ≥130 ms, 73% had left bundle branch block and 26% were in atrial fibrillation at the time of implantation. Large geographical variations in clinical practice were observed. Conclusion: CRT Survey II provides a valuable source of information on contemporary clinical practice with respect to CRT implantation in a large sample of ESC member states. The survey permits assessment of guideline adherence and demonstrates variations in patient selection, management, implantation procedure and follow-up strategy. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology
Συγγραφείς:
Dickstein, K.
Normand, C.
Auricchio, A.
Bogale, N.
Cleland, J.G.
Gitt, A.K.
Stellbrink, C.
Anker, S.D.
Filippatos, G.
Gasparini, M.
Hindricks, G.
Blomström Lundqvist, C.
Ponikowski, P.
Ruschitzka, F.
Botto, G.L.
Bulava, A.
Duray, G.
Israel, C.
Leclercq, C.
Margitfalvi, P.
Cano, Ó.
Plummer, C.
Sarigul, N.U.
Sterlinski, M.
Linde, C.
Λέξεις-κλειδιά:
adult; aged; Article; atrial fibrillation; cardiac patient; cardiac resynchronization therapy; cardiovascular mortality; clinical evaluation; clinical practice; European; female; follow up; health program; health survey; heart failure; heart left bundle branch block; human; major clinical study; male; morbidity; New York Heart Association class; practice guideline; protocol compliance; QRS interval; cardiac resynchronization therapy; cardiology; clinical trial; Europe; medical society; middle aged; multicenter study; practice guideline; procedures; prognosis; prospective study; questionnaire; survival rate; trends, Aged; Cardiac Resynchronization Therapy; Cardiology; Europe; Female; Heart Failure; Humans; Male; Middle Aged; Morbidity; Practice Guidelines as Topic; Prognosis; Prospective Studies; Societies, Medical; Surveys and Questionnaires; Survival Rate
